The dos and don’ts of going to the ER

ERs across the country are seeing a rapid return to pre-pandemic volume. My ER in Burbank, California, has had some 200-plus patient days recently.

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As we head deeper in spring and then summer – traditionally the busiest time for ERs – and in the context of reiterating the importance of using your local ER appropriately, I wanted to present some practical “dos and don’ts.”

Do not “wait it out.” If you have dangerous cardiac symptoms like chest pain or stroke-like symptoms including severe headache, dizziness, weakness to one side of your body, facial droop or slurred speech. These symptoms could signify a heart attack or stroke – life-threatening conditions that are time-dependent. If not identified and treated within a matter of hours, the damaged part of your heart or brain could be unsalvageable

A study from spring 2020 surveyed nine major hospital systems and found the number of severe heart attacks being treated in the U.S. had plummeted by approximately 40%. Patients were either afraid of going to the ER because of fear or COVID or were unable to access their primary care doctors or specialists. Early treatment with clot-buster medications or a trip to the catheterization laboratory is critical. As we say in the ER, “Time is heart (and brain).”

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Do bring a list of your doctors, known medical problems and prescriptions, including your dosage and any recent changes. Do not assume such critical information is “in the computer.” Even though all hospitals use an electronic medical record, they’re often not integrated. It’s extremely difficult and time-consuming for us to call other hospitals or pharmacies for this information. Time that would be better served attending to your emergency!

Also, if you were referred by a doctor’s office or urgent care center for an “abnormal” lab value or image, please bring the report and CD of the image with you. 

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Do not assume you’ll be able to jump the line if you come by ambulance. It won’t work. And it’s a misuse of the EMS system. As with all visitors to the ER – whether you walk in or come by ambulance – you’ll be quickly evaluated by a triage nurse who will determine whether you need to be seen immediately by a doctor based on an assessment of your “chief complaint” and vital signs. If you’re assessed to be “stable” and asked to wait in the waiting room, this is a good thing! It means you likely do not have a life- or limb-threatening emergency. Please be patient.

Do focus on the reason that brings you to the ER. As much as we’d love to help you out with multiple concerns, we simply don’t have the time, staff or resources. Please don’t be upset if your doctor asks you “What’s the main reason you came to the ER today?” Or “What’s bothering you the most?” We can always refer you back to your primary doctor or a clinic to assess most chronic medical concerns.

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